目标性监测在留置导尿管相关感染中的作用

Targeted surveillance of urinary tract infection in hospital patients

目的研究留置导尿管相关泌尿系感染(urinary tract infection,UTI)目标性监测是否降低尿路感染发生率,并分析其危险因素,为医院感染管理和控制提供科学的依据。方法采用目标性监测方法,对2011年所有住院患者发生导尿管相关泌尿系感染情况进行调查与分析。结果 769例留置尿管患者,发生泌尿系感染136例,感染率为17.69%,与去年相比感染率明显下降,监测发现感染与基础病、无菌操作、手卫生及导尿管留置时间有关;尿培养病原菌依次排列为:大肠埃希菌、粪肠球菌、金黄色葡球菌、铜绿假单胞菌、克雷柏杆菌、真菌等。结论临床上应严格掌握留置导尿的适应症,病情允许时尽可能缩短留置时间。同时,要严格无菌操作,做好导尿管的护理、定期更换导尿管及尿袋、合理使用抗生素,降低泌尿系感染的发生率。

Object： To analyze the affect and the risk factors of targeted surveillance in hopital patients of urinary tract infection, to provide a scientific basis for hospital infection management.Method： Monitoring and analyzation all patients in 2011 with catheter-related urinary tract infection. Result： 769 cases of patients with indwelling catheter, 136 cases of urinary tract infection happend, and it’s incident rate was 17.69% with significant decrease compared with last year. monitoring found to be infected with the underlying disease, aseptic technique,hand hygiene and catheter indwelling time-related; Urine culture pathogens of priority as follows： Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Ke Leibo bacteria, fungi and so on.Conclusion： Controling the indication, shortening the time of indwelling catheter. Keeping strict aseptic technique, good catheter care, regular replacement of the catheter, rational use of antibiotics are effective measurement to reduce the incidence of urinary tract infection.